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Individual

MRS. KARENA DIANE SCHROEDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
3534 BROOKLYN AVE, FORT WAYNE, IN 46809
(260) 478-5230
(260) 478-5235
Mailing address
4251 LAHMEYER RD, FORT WAYNE, IN 46815-5676
(260) 432-4700
(260) 459-9262

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05008969A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000482874
ANTHEM BCBS
IN
01
100257920
MEDICAID - GROUP
IN
01
1424
PHP
IN
05
200838660
IN
01
35179001202
CARESOURCE
IN
01
4423623
AETNA
IN
Enumeration date
12/15/2006
Last updated
05/16/2011
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